Doctors Shouldn't Marry Other Doctors

I found an article here in CNNMoney about a husband and wife who are both residents and looking at a huge amount of debt. I know it's early but it is something to consider later on down the road. I think their case is extraordinary because they are both training to be physicians and are shouldering a huge amount of debt from medical school. I love how all these articles always paint doctors as these hard luck cases..."such are the lives of medical residents: med school graduates getting years of on-the-job training, putting in brutal hours for salaries that, on an hourly basis, work out to a little more than they could earn stocking the shelves at Costco." I actually read that the average resident makes 12/hr given the amount of hours they work relative to the pay. And no I am not making this number up out of thin air, I just can't remember where I read this. Another great quote in the CNNmoney article is "for this generation of doctors, and for Meg and Chris in particular, financial security won't come guaranteed with their medical licenses. As health-care economics squeeze physician salaries, rising college and med school tuitions are putting young doctors ever deeper in the hole." Does this mean that doctors will have to be waiting tables on the side? Anyways it's a good read and the take home message here is if you have to get married, don't marry someone that has just as much or more debt than you because not even a doctors salary can get you out of that hole.
Graphics Credit: http://money.cnn.com/2007/11/16/pf/young_doctors.moneymag/index.htm

What Does it Take to be Good a Doctor?

According to the Texas Medical Association there are three personality traits and disorders common to physicians: narcissitic, obsessive-compulsive and antisocial. I think the main question here is whether these traits are endemic amongst medical pratitioners (i.e. the trait makes the physician who he or she is), or does it manifest itself in the individual as they are preparing to enter the medical profession. I believe the later is true. As a disclaimer I am in no way saying that all physicians exhibit these personality traits. I actually googled "what personality traits make a good physician" and this site came up.

"Three personality traits and disorders will be discussed in this module: narcissistic, obsessive-compulsive,and antisocial. These three are the most commonly found among physicians.

Personality disorders are pervasive chronic psychological disorders which can greatly affect a person's life. Having a personality disorder can negatively affect one's work, one's family, and one's social life.

Personality disorders exist on a continuum from mild (traits) to more severe (disorders) in terms of how pervasive and to what extent a person exhibits the features of a particular personality disorder. While most people live normal lives with mild personality traits, during times of increased stress or external pressures (work, family, a new relationship, etc.) the symptoms of the personality disorder may intensify and seriously interfere with emotional and physical functioning.

Those with a personality disorder possess several distinct psychological features including disturbances in self-image; inability to have successful interpersonal relationships; inappropriate range of emotion; misperceptions of themselves and the world; and difficulty possessing proper impulse control. These disturbances combine to create a pervasive pattern of behavior and inner experience that is quite different from the norms of the individual's culture and that often tend to be expressed in behaviors that appear more dramatic than what society considers usual. Consequently, those with a personality disorder often experience conflicts with other people and vice-versa.

Narcissistic Personality Disorder

• Has grandiose sense of self-importance
• Is preoccupied with fantasies of success, power, brilliance
• Believes self to be “special”
• Requires excessive admiration
• Has a sense of entitlement
• Is interpersonally exploitative
• Lacks empathy
• Shows arrogant, haughty behaviors

Narcissistic people try to sustain an image of perfection and personal invincibility for themselves, and attempt to project that impression to others as well. Those with Narcissistic Personality Disorder project an inflated sense of self because typically beneath that image of grandiosity is often an insecure person with very low self-esteem.

Narcissistic Personality Disorder tends to be more common in men than women. Because of their inflated sense of self-importance, narcissists tend to be driven to achieve high levels of accomplishments.

Obsessive-Compulsive Personality Disorder

• Preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency, as indicated by four or more of the following characteristics:
• Preoccupation with details and order
• Perfectionism that interferes with task completion
• Excessive devotion to work
• Rigidity and stubbornness
• Pack-rat (keeps evrything)
• Expectation of complete compliance
• Miserly (financial)

Obsessive-Compulsive Personality Disorder is not the same thing as Obsessive-Compulsive Disorder.
Individuals with Obsessive Compulsive Personality Disorder (OCPD) often are characterized by their lack of openness and flexibility in their daily routines as well as by problems with interpersonal relationships and expectations. An overwhelming preoccupation with orderliness, perfectionism and control of their lives and relationships makes treatment difficult.

Individuals with OCPD have difficulty incorporating new and changing information into their lives. Their ability to work with others is equally affected, since they see the world as black and white--their way of doing things and the wrong way of doing things.

Examples of OCPD would be checking and rechecking dosages; excessive work-ups, etc.

People with OCPD do not feel embarrassed or shameful because of their behavior, whereas people with OCD have a sense of shame. Behavior of the individual with OCPD affects everyone else, making them feel uncomfortable, while behavior of the individual with OCD affects primarily the individual and not everyone around him/her.

Antisocial Personality Disorder

A pattern of disregard for and violation of the rights of others, with three (or more) of the following traits:

• Repeated unlawful behavior
• Deceitfulness
• Impulsivity
• Irritability and aggressiveness
• Recklessness
• Consistent irresponsibility

The main features of Antisocial Personality Disorder (ASPD) revolve around a pervasive lack of remorse or lack of exhibiting any feelings at all. While it tends to be most common among those who run into trouble with the law, there are those individuals with a milder form. We may know him as the politician who feels comfortable lying continuously to the public or the neighbor who constantly cheats on his wife, gambles away the family money, or runs a shady business operation cheating others out of their money.

Examples of physicians with Antisocial Personality Disorder:

Insurance fraud

1. Medicare/Medicaid fraud
2. Over-prescribing
3. Over-utilizing for personal gain (ordering too many tests)
4. Sexual predators"

How Smart to You Have to be to Become a Doctor?

All of us wonder this one time or another...how smart to you have to be to be a doctor? I actually think about this every hour of every day, but I am a little obsessive compulsive. Well that question came up in YahooAnswers not too long ago and I thought I would share it with everyone. Apparently answerer 2 thinks that you have to be the Gary Kasparov of math to become a doctor. I especially like answerer 1's suggestion that you can't gag when you see blood. And then there is self deprecating answerer 6 who suggests to our young inquisitor that he pursue a Caribbean medical school and even provides a website address...I think he maybe working for them. One person states that their brother was pretty much a complete idiot in high school and now he is a dentist "making loads of cash." I didn't know having loads of cash was the point of becoming a doctor. I think answerer 3 is by far the most helpful and thoughtful not only in her answer but also by the fact that she left an email address for the young lad to contact her. Yahoo answers will never let you down. Click here to see it for yourself. (All those typos btw are theirs, not mine)

How smart do you have to be to become a doctor and to even get into medical school? like i know you hae to be good in math, so would have to be in challelnge math in highschool for the whole five years???

Answerer 1 I'm not so sure that you have to be a genius or anything. But more of a interest in what a doctor has to do and have a strong passion for it. For example, if you don't like blood and it make you gag I wouldn't go into the medical field. But if you love the idea of being a doctor and are interested but you don't think your smart enough, try as much as possible. Or read books and study up.

Answerer 2
You have to be VERY good in science and math especially
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Hope that helped Good Luck

Answerer 3
Yes, math and science, do well in those it will take you very far.

Math really isn't a big deal, actually. The only math you need to get into medical school is general 2 semesters of college math, usually one statistics and one calculus or similar class. Although it is important to do well in these classes, a B probably isn't a big deal (and statistics really isn't hard at all if you go to class).

You do need to be good at science...biology, chemistry, and physics are all classes you need to take and do well in order to get into medical school, and all three are on the MCAT. The only thing you need to do in highschool is keep your grades up enough to get into a good 4-year university with a good science program. Medical schools don't look at your highschool transcripts, so it really doesn't matter what you take in highschool. That being said, a good solid science background will make your life easier in college.

In college you need to keep about a 3.5 GPA to get into medical school, and you need to get a 30 on the MCATs (out of 45).

If you have any more questions about what you need for medical school, please feel free to email me at goodee_2_sandals@yahoo.com.

Answerer 5
i would do an internship at a doctors office and see what they actually do... or work as a medical assistant to decide if working in that environment is something u'd wanna do for the rest of ur life.
i definetly think that you have to be decent in math and science, nothing spectacular though. Also alot of it is memorization... think of ALL the different body parts and diseases that a doctor must remember and have knowledge of at any given time... having a passion and love for the job certainly helps u memorize

Answerer 6
It's not necessarily smarts... you have to have good discipline, work really hard and be really motivated. I am a 4th year medical student and personally i don't think i am very smart... but i work hard. You can go to medical school out of high school to a 6 year program. The only thing is you have to go abroad. if you want to go to medical school in US you have to do 4 yrs of premed and 4 years of medical school(total 8). If you go to a place like the Caribbean you can be done in 4 years. here is a site to help you... good luck
http://www.bestforeignmedicalschools.com

Answerer 7
math in high school is there to get you prepared for college math. My brother was never a good math student in high school (C's and B's) but he managed to get by. Now he is a dentist making loads of cash. If you really want to go into the medical field then i would try taking some math courses to the side or during summer for summer school. The only way to like math is to understand it, if you don't understand it then you don't know if you like it. But to answer your question furthermore, i would say that you probably have to get into the basics of calculus to become a doctor. This also depends on the college you choose.
Courtesy of: http://answers.yahoo.com/question/index?qid=20080330183345AAaonrF

The Day in the Life of a Physician

It's really hard to grasp what a doctors life is like day to day. There are people out there that make it sound like your personal life is over once you are a doctor. You will have no time for family, friends, hobbies...nothing. It sounds pretty bleak right? I know that shadowing a doctor is supposed to provide a premed with an honest view of what it is like to be an MD, however, I doubt that any shadowing program allows you to go whom with the doc and see what their life is like outside of the hospital. We are made to believe that their entire life is the hospital when in fact we all know that there are doctors who have happy functional fulfilling lives outside of medicine. I grew up not knowing any doctors. I didn't even have a regular pediatrician because we moved around so much, so my idea of what it is like to be a doctor is completely skewed. All I can go by is the advice that has been given to me by adcom members and advisors who all suggest that you are pretty much giving up your life as you know it. Maybe it is just their way of weeding out the dedicated individuals from the slackers. Either way I am beginning to think that doctors maintain this monastic lifestyle devoid of any kind of joy. I set out to find out what life is really like for a doctor on and off of work. So I did what any self respecting blogger would do...I googled "a day in the life as a physician." One of the first things to come up was a series of articles on a website called The Next Generation. They highlight what life is like for four different MD's from different specialties. Question two in an interview with an internist named Dr. Douglas Kelling asks:

2. What is your schedule like? How much time do you spend with each patient? When I am not on vacation, I work 7 days a week. Monday through Friday I start my hospital rounds between 5:30 am and 6:30 am. Rounds are usually completed by 8:30 am. I then go to my office, which is attached to the hospital. Monday through Thursday I see patients from 8:30 am until 6:00 pm. I take about 1/2 hr for lunch. I eat in the office. On Fridays, I see patients from 8:30 until noon. Friday afternoon is devoted to education and paperwork. After my office is closed, I go back to the hospital to work up new patients. About 7:00 pm I go home for supper. I return to the hospital about 8:00 pm and stay until 10:00 to 10:30 pm to see patients and do paperwork. On Saturday and Sunday I work at the hospital from 9:30 am until 5:00 pm rounds on patients and do paperwork.

This guy sounds intense. Maybe everyone was right about a doctors lifestyle. Someone please correct me if I am wrong in my assumptions.
Photo Credit: http://www.nextgenmd.org/vol1-5/kellingv1i5.html

Fact or Fiction?

I have been reading up on the numerous "medblogs" that litter the "internets." I am intrigued by the fact that there is this whole genre of blogs that are out there that go mostly unnoticed by the general public. A person could spend all day reading and still not catch up on all the new posts. It's like trying to fit the smithsonian into one day. As I read these blogs from people from all facets of the medical field I am reminded of the fact that I have a long way to go. I started obsessing over the fact that medical school applicant numbers increase from year to year, and it is getting more and more competitive to gain entrance into medical school. Of course this is all anecdotal from pre-meds who are trying to scare the shit out of each other while listening to a lecture on fisher projections and redox reactions. Students often make these preemptive proclamations to also soften the blow of a rejection letter months down the road. I set out to find out for myself whether there was any truth to these rumors, and because I am guilty of regurgitating the same "facts" all the time.

According to AAMC more than 42,300 individuals applied to enter medical school in 2007, an increase of 8.2 percent over 2006. Nearly 32,000 were first-time applicants, the highest number on AAMC record. And according to amednews.com the American Assn. of Colleges of Osteopathic Medicine also saw its applicant pool reach a record level for the 2007-08 academic year, with 11,500 candidates." So how many were accepted and enrolled out of this huge applicant pool? AAMC says that the 2007 entering class to U.S. medical schools is the largest in the nation's history, according to new data released today by the AAMC (Association of American Medical Colleges). The number of first-year enrollees totals almost 17,800 students, a 2.3 percent increase over 2006. The bad news is that "overall, the academic credentials of applicants to medical school this year were stronger than ever before, with the highest MCAT scores and cumulative grade point averages on record. In addition, over the past five years there has been an increase in applicants' average amount of experience in premedical activities, including time spent in medical research and community service in clinical and nonclinical settings."

The good news for us and the bad news for the public is that "the need for more doctors is real and will become more urgent as our population grows and ages," said AAMC President Darrell G. Kirch, M.D. "This increase is a significant step in the right direction, and we are pleased that 71 U.S. medical schools plan to expand their class sizes over the next five years. But clearly, we must find additional ways to stimulate more growth in medical school capacity so that we have enough doctors to care for our nation in the coming decades."

However there are numerous barriers to increasing enrollment that need to be addressed including available scholarships, classroom space, ambulatory preceptors and costs. I guess there was some truth to all those pre-med horror stories, but at least there is demand for the supply. Now all we need to do is fix the distribution.

Student Admitted to Medical School Without Ever Taking MCAT

An extreme case of nepotism or a gross oversight? A student was admitted to the University of Florida School of Medicine by its Dean, Dr. Bruce Kone, "over the objections of the college's selection committee." Apparently not only did he not take the MCAT, but he "did not apply through AMCAS by the usual deadline - instead, he applied by special permission, given by Dr. Kone, in February." It is not clear what prompted the dean to make this kind of concession for one student, but the article suggests that it may have been political influence by Governor Charlie Grist that expedited the students admission. Governor Grist, who is a friend of the students father, wrote a letter of recommendation for the student when he originally applied to the UF's accelerated program in 2007 in addition to a letter of recommendation from Sen. Ken Pruitt.

Before I go any further you should just read the rest of the article for yourself here. It makes for a quite an interesting read. I wish I had those kind of recommendation letters. It's amazing to me that we go through all this work to get into medical school when there are others out there that are being accepted without the requisite credentials. We should all email the dean at bkone@ufl.edu and let him know that this kind of behavior is unfair.
Aaron Daye/The Gainesville Sun

Older Doctors Hate Their Jobs!?

"Fifty-seven percent of older physicians said they would not recommend medicine as a career to their own children. Similarly, 44 percent said they would not select medicine as career if they were starting out today."

This is a quote from an article I found, Many older doctors plan to phase out their practice, while snooping around the Internet and it is really depressing for those of us who want to become doctors. It doesn't really say why more than half of all older doctors polled wouldn't recommend medicine as a career even to their own children. Is it really that bad? Why are they so disgruntled about their jobs? Why are we trying so hard to get to a place that they are trying so hard to get out of? It is really making me think twice about whether to even pursue this. I wonder what jobs they would opt for instead of medicine? I bet it's a lot easier to make that kind of a claim when you are pulling in $150,000 a year. I am sure they wouldn't be happy making $30,000 a year as a mouse testicle remover or maybe a Walmart greeter. I guess the bright side of this is that there are so many doctors that are leaving their practices that there is going to be a shortage. More jobs for us! I think most doctors are just old and grumpy, as can be seen in the photo above.
Photo Credit: http://www.spartantailgate.com/forums/msu-red-cedar-message-board/302784-old-man-walmart-application.html

The Optimizers

What is an optimizer you ask? Well it is what we refer to as any person who goes above and beyond what is needed for the task at hand in order to either elevate their status amongst their peers and or instructor, or to ensure that they maintain their A+ average. Unfortunately for us, re-entry students are often seen as optimizers. You know the type. It's usually the older person in the front row of every lecture, who raises their hand for every question rhetorical or not, and who is without fail always the last one to leave the classroom after class has been dismissed. I used to mock these individuals in undergrad and now I have become one. So please go easy on us because we really don't mean to do it intentionally. It's just that time is so much more precious to us and we must take advantage of every second of the day because this may be our last shot at getting into med school.

Update: I am beginning to realize that most premeds are optimizers. Maybe this field just attracts that type of individual.
Photo Courtesy of: Blend Images (RF) Image #23292391